PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Collateral Circulation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1988

[Regional cerebral blood flow and the infarct volume in obstruction of the internal carotid artery in relationship to the source of the collateral circulation].

The cerebral blood flow was examined by means of Obrist's 133Xe-inhalational method, cerebral angiography, and computer-aided tomography of the head in 100 patients with occlusion of the internal carotid artery. The findings obtained have revealed a correlation between the level of the compensatory collateral blood supply of the bed of the middle cerebral artery (MCA) and the source of collateral blood circulation. The authors have demonstrated the vulnerability of the MCA bed secondary to a low level of blood supply persisting despite the functioning of all pathways of the collateral circulation.

Brain↗
PubMedDate not supplied

Follow-up assessment of the collateral circulation in patients with Kawasaki disease who underwent dipyridamole stress technetium-99m tetrofosmin scintigraphy.

To assess the alteration of myocardial ischemic findings and the role of collateral vessels in patients with Kawasaki disease (KD), we used dipyridamole stress technetium-99m tetrofosmin (Tf) single photon emission computed tomography (SPECT). A comparison study of coronary angiography and dipyridamole stress (0.70 mg/kg) Tf-SPECT was repeated at least twice in 20 patients. The subjects included 7 patients with coronary stenosis, 1 with pre- and post-coronary artery bypass grafting (CABG) due to coronary stenosis, 1 with progression to coronary stenosis, and 11 with persistent coronary aneurysms. In the stenosis group, Tf-SPECT revealed that 6 of the 7 patients had some degree of ischemic findings, and 5 of these 6 did not show any change in their ischemic findings during follow-up. In 1 patient, the ischemic findings changed according to the collateral circulation changes. The patient who underwent CABG had pre-CABG ischemic changes that disappeared after CABG. In the patient whose coronary arteries progressed to stenosis, the ischemic findings progressed as the coronary stenosis progressed. In the persistent aneurysm group, there were no ischemic findings. In the future Tf-SPECT may become one of the most useful methods for monitoring the progressive changes of myocardial ischemia in KD.

Adolescent↗
PubMed1995

Unusual coronary collateral circulation: filling of a totally occluded left anterior descending artery by direct continuity from a left posterior descending artery. A case report.

A patient with an unusual coronary collateral circulation is presented. The left anterior descending artery, which was totally occluded proximally, was filled directly by a continuation of the left posterior descending artery. A thallium stress test revealed normal perfusion in the territory of the left anterior descending artery.

Collateral Circulation↗
PubMed1985

The effect of cardiac hypertrophy on the coronary collateral circulation.

We have previously shown that dogs with renal hypertension and left ventricular hypertrophy have larger infarcts (per risk area size) than do control animals. A potential explanation for this is that collateral resistance is higher in these dogs. Paradoxically, previous postmortem studies in human hearts with left ventricular hypertrophy have suggested that coronary collaterals are actually increased in this condition. To test the hypothesis that left ventricular hypertrophy is associated with alterations in coronary collateral resistance, studies were performed in dogs with renal hypertension and left ventricular hypertrophy and in patients with aortic valvular disease at the time of cardiac surgery. With an isolated, adenosine-vasodilated, blood-perfused cardiac preparation, collateral and normal zone pressure-flow relationships were established by means of radioactive microspheres in nine dogs with renal hypertension and left ventricular hypertrophy and in 17 controls. Collateral resistance calculated from these pressure-flow relationships were similar in both groups (4.0 +/- 0.7 in dogs with renal hypertension and left ventricular hypertrophy and 3.9 +/- 0.4 mm Hg/ml/min/100 g in controls). In addition, normal zone resistance was not different between groups (transmural resistances 0.17 +/- 0.01 in controls and 0.18 +/- 0.02 in dogs with renal hypertension and left ventricular hypertrophy. In five patients with aortic valve disease, left ventricular hypertrophy, and normal coronary arteries and in six patients without left ventricular hypertrophy who had normal left anterior descending coronary arteries, a 7 MHz suction-mounted echo transducer was used to monitor systolic wall thickening during transient occlusions of the left anterior descending artery at the time of cardiac surgery. Because noncollateralized myocardium ceases to contract promptly after coronary occlusion, this approach provides an indirect index of collateral perfusion. Twenty seconds after the onset of coronary occlusion, systolic thickening had markedly decreased in both groups (15 +/- 10% of control values in nonhypertrophied hearts and 10 +/- 10% in hearts with left ventricular hypertrophy; p = NS between groups). Thus the severity of contraction abnormality induced during transient coronary occlusion in these two groups of patients was similar, suggesting that the degree of severity of ischemia was comparable between the two groups. We conclude that collateral resistance is not altered by hypertension and left ventricular hypertrophy and that left ventricular hypertrophy in patients is not associated with functional evidence of an enhanced collateral circulation.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1980

Functional significance of coronary collateral circulation during dynamic exercise evaluated by thallium-201 myocardial scintigraphy.

Sixty-five patients with angiographically documented coronary artery disease were investigated by thallium-201 (201Tl) scintigraphy to determine the role of the collateral circulation during dynamic exercise. Fifty-three patients had complete proximal occlusion of at least one major coronary artery. One patient had total occlusion of all three major coronary arteries. Sixty-four collateral channels were identified, graded, and compared with corresponding regions of the myocardial scintigram. Tracer uptake was also graded and classified as various degrees of protection from ischaemia. A significant correlation between good collaterals with complete protection and poor or absent collaterals with no protection was noted. Seventeen patients (20 occluded vessels) had total coronary occlusion without myocardial infarction. Collaterals conferred protection in 9/15 occlusions whereas no protection was seen in five occlusions without collaterals. There was no difference in the protective role of homocoronary and heterocoronary collateral vessels. Hypertrophy of the first septal left anterior descending perforator conferred significant protection from ischaemia in contrast to bridging collaterals and ghosting. During exercise the right coronary bed is preferentially protected from ischaemia, in contrast to the left anterior descending territory. This probably reflects the direction of a transmural flow gradient between left and right ventricles during exercise.

Adult↗
PubMedDate not supplied

[Adaptation of the myocardium to ischemia: study of suspension of the mitochondria as related to the development of the collateral circulation].

The authors developed an experimental model by means of which they established in the dog the role of short duration ischaemia (1-5 minutes) in triggering local haemodynamic changes that led to the rapid development of a collateral circulation, with retrograde filling, able to furnish subsequently blood supply to the distal segment of a main coronary artery obstructed for 20 minutes. Histological study, electron microscopy, biochemical tests and mitochondrial suspensions revealed the value of the latter method, being the most reliable test for appraising the remaining postischaemic functional potential. The data obtained may serve as a basis for understanding the role of the coronary colateral circulation in man, in coronary obstruction, and the means of developing this circulation.

Animals↗
PubMed2006

Influence of oxidative stress on the development of collateral circulation in total coronary occlusions.

OBJECTIVES: The purpose of this study was to investigate whether the levels of total antioxidant capacity (TAC), total peroxide and oxidative stress index (OSI) are associated with the development of collaterals in total coronary occlusions. DESIGN AND METHODS: Our study group contained 176 consecutive men patients with single-vessel TCO, 94 of whom had poorly developed coronary collateral, while 82 had well-developed coronary collateral. TAC and total peroxide concentration were measured of plasma. The ratio of TAC to total peroxide was accepted as an indicator of oxidative stress. RESULTS: The values of total peroxide and OSI in the Group I were significantly lower than that in Group II (p<0.001, for both). TAC levels were significantly higher in patients with poorly developed collaterals than in well-developed collateral group (p<0.001). OSI values were also significantly different among the Rentrop class-0, -1, -2 and -3 (ANOVA p<0.001). We found significant correlations between collaterals score and TAC, total peroxide and OSI levels (p<0.001 for all). In multiple linear regression analysis, total peroxide and OSI were independent predictors of collaterals score (p=0.006 and p<0.001 respectively). CONCLUSION: This study clearly demonstrates that the level of OSI is independently and positively associated with the presence of collateral circulation in total coronary occlusion patients.

Antioxidants↗
PubMedDate not supplied

Contractile performance, mitochondrial function and blood flow distribution in porcine heart with induced coronary collateral circulation.

Progressive stenosis of the proximal left anterior descending coronary artery in young pigs was surgically induced over eight weeks and was accompanied by the development of a coronary collateral circulation originating from the right coronary artery. The antero-apical left ventricular myocardium dependent on this induced collateral blood supply became hypokinetic compared with the other regions of the left ventricle in the same hearts, and compared with the same region in different hearts, where the native circulation exists. Regional myocardial mechanics determined as fractional systolic shortening was 12.5 +/- 1.5% in normal regions, 0.7 +/- 2.4% in collateral-dependent myocardium, and in acutely ischemic myocardium was -2.0 +/- 1.3%, indicative of systolic lengthening. The rate of state 3 respiration of isolated mitochondria was depressed by 20% in collateral regions and by 64% in acutely ischemic regions relative to values obtained in mitochondria from respective normal myocardium (300 natoms of oxygen/min/mg mitochondria protein). Regional myocardial blood flow determined by 15 mu radionuclide labelled spheres revealed subendocardial hypoperfusion of 0.34 +/- 0.11 ml/min/g tissue in the collateral-dependent regions compared to 1.06 +/- 0.26 ml/min/g tissue in the normal regions. Transmural ischemia was observed (less than 0.10 ml/min/g tissue) in regions subjected to acute coronary artery ligation. Light microscopy revealed patchy fibrotic lesions predominately associated with the subendocardial half of the collateral dependent myocardial wall. Accordingly, the hypokinesia of collateral-dependent myocardium is more likely the result of blood flow abnormalities and loss of contractile elements than from mitochondrial dysfunction.

Animals↗
PubMed2003

Chronic dialysis fistula thrombosis treatment by means of endovascular recanalization with surgical exclusion of developed collateral circulation.

Fistula thrombosis is the most common and dangerous complication resulting in vascular access insufficiency. The most "tricky" lesion of dialysis fistula is chronic thrombosis which occurs when only a short section of efferent vein becomes clotted and collateral circulation enabling further, limited in time functioning of dialysis fistula is created. In 7 chronic thrombosis patients subjected to treatment by means of endovascular recanalization, developed collateral vessels were surgically ligated to obtain single-canal blood flow. The recanalization procedure involved making a puncture, inserting a guide wire and performing balloon angioplasty. Simultaneously, 2 or 3 collateral veins were incised and ligated. The result obtained in all the 7 cases was considered successful as all fistulas remained a 100% patent 6 months after the procedure.

Angioplasty, Balloon↗
PubMed1984

Restoration of post-thrombotic peripheral collateral circulation in the cat by ketanserin, a selective 5-HT2-receptor antagonist.

In cats, an acute thrombotic obstruction of the aorta inducing continuous platelet activation, was produced by permanent ligation above the trifurcation, temporary ligation below the caudal mesenteric artery and production of a stasis thrombus in the segment. Before, 5 min, 24 hr and 48 hr after surgery, plethysmographic systolic blood pressure in fore- and hindlegs, and clinical scoring of the hindleg function were performed; at 72 hr, venous occlusion plethysmography for quantification of blood flow was performed and collateral vascular resistance was calculated. Thrombotic occlusion resulted in a loss of adequately functioning collateral circulation as evidence by the changes in both the objective and the clinical parameters. Pre-treatment with ketanserin (1.25 mg/kg i.p. daily) significantly improved the objective circulation parameters blood pressure ratio, blood flow and collateral vascular resistance and restored the clinically scored function of post-thrombotic collateral function. Provided platelet activation contributes to human vascular pathology, a similar mechanism may be involved in the potential effect of ketanserin in man.

Animals↗
PubMedDate not supplied

[Functional significance of the internal carotid arteries and collateral circulation in cerebral aneurysm surgery].

The functional significance of the internal carotid artery was appraised in 18 patients with arterial, in 8 with arteriovenous aneurysms and in one patient with atherosclerosis of the cerebral vessels. The appraisal was based on changes in the intracarotid pressure and regional cerebral blood flow (quantitative criteria) in temporary occlusion of the internal carotid artery with a double-lumen balloon catheter and on the change in the patients' clinical condition during temporary or stationary arrest of blood flow through the internal carotid artery that is studied. In large arteriovenous aneurysms, the collateral circulation ensures adequate blood supply to the brain tissue on the side of temporary occlusion of the internal carotid artery. The functional importance of the internal carotid artery in patients with arterial aneurysms points to the possibility of reconstructive operations in aneurysms of the internal carotid artery which are inaccessible for direct intervention. However, it is expedient in every case to make sure that the operation is safe by preoperative appraisal by means of the suggested method.

Adult↗
PubMed1979

Survival with total occlusion of the left main coronary artery. Significance of the collateral circulation.

Four patients with total occlusion of the left main coronary artery are described. Angina pectoris was severe (NYHA class 3--4) and had lasted 20 months to seven years. Three patients had experienced a myocardial infarction. All displayed large collaterals arising from a nearly normal right coronary artery and feeding both the left anterior descending and the left circumflex arteries. The left ventricular ejection fractions ranged from 20% to 65%, and all patients had varying degrees of left ventricular asynergy. Coronary artery bypass surgery resulted in a marked improvement in three patients; one patient who underwent an aneurysmectomy died two months after the operation. The data show that total occlusion of the left main coronary artery is compatible with survival if adequate collateral supply develops from the right coronary artery. In this rare angiographic subset collateral circulation is clearly functionally significant.

Adult↗
PubMed2002

Plasma level of homocysteine is inversely-associated with the development of collateral circulation in patients with single-vessel coronary artery disease.

Homocysteine induces endothelial injury and inhibits endothelial cell proliferation, which is a key role in angiogenesis. The purpose of this study was to investigate whether the plasma level of homocysteine is associated with the development of collaterals in patients with single-vessel coronary artery disease (CAD). Among a series of 105 male patients with angiographic estimation, 49 with single-vessel CAD were intensively investigated. Development of collaterals was classified by Rentrop's method. Univariate and multivariate analyses revealed that hyperhomocysteinemia negatively affected the development of collaterals (p=0.0015 and 0.0011, odds ratio 0.69, 95% confidence interval 0.52-0.90), whereas the duration of angina and percent stenosis evaluated by quantitative coronary angiography had a positive affect. Moreover, the level of homocysteine in the group with poorly developed collaterals (n=7, Rentrop class 0 and 1) was significantly higher than that in the group with well-developed collaterals (n=12, Rentrop class 2 and 3) of the patients with single-vessel disease showing total occlusion (p=0.034). This study clearly demonstrates that the plasma level of homocysteine is independently and inversely associated with the development of collateral circulation in CAD patients. Homocysteine might be a new undesirable aspect of ischemic heart disease through its inhibition of collateral development.

Adult↗
PubMed1976

[A functional-morphologic analysis of reactive changes in nerve fibers during development of collateral circulation in nerves].

After stopping the blood circulation along the femoral artery the collateral blood circulation is developing unevenly in different nerves. It depends on the architectonics of blood vessels of the zone. In time the intravenous anastomosis in the distal part of the ischiatic nerve sharply increases. It is pulsing and compressing the nerve bundles and may have a negative influence on nerve fibres. Reactive morphological changes of the axis cylinder, myelin incisions and Ranvier's constrictions are found in such a nerve. The analysis has shown that the changes noted have a character of local non-specific process accompanying physiological manifestations of parabiosis.

Animals↗
PubMed1987

[Methods of angiography and cerebral blood flow determination in evaluating the status of the collateral circulation].

It is a known fact that the value of the cerebral blood flow (CBF) in the hemisphere where the internal carotid artery (ICA) is occluded may serve as a quantitative parameter of the collateral blood supply (CBS). Comparison of the findings obtained by cerebral panangiography (CPAG) versus inhalational studies of the CBF in 38 patients with occluded ICA has demonstrated that although CPAG is quite adequate for assessing the status of the collateral blood circulation routes, a more optimal method for evaluating the status of the CBS is measurement of the CBF since in at least half the cases CPAG yields inaccurate information about the CBS in patients with impaired cerebral blood circulation. The studied methods are not competitive but should be used in conjunction for obtaining the most complete information about the cerebral hemodynamics which is particularly important to consider in making decisions about the advisability of surgical intervention.

Adult↗